September 7, 2018
Help Us Help You
This week, MHA's Government Affairs team asked hospital CEOs for their help in completing a survey to gather data on medical malpractice trends at Maryland's hospitals.
This request is about much more than a survey, however. It's about equipping MHA with the tools we need to be an effective advocate in Annapolis.
The 2019 General Assembly session promises to be a challenging one, with significant shakeups in leadership and in the composition of key committees, as well as a slew of wholly new legislators. That means we have real opportunities to educate and influence those who have the power to effect change on issues that are important to hospitals.
Medical liability has always been difficult, given the emotional weight its stories carry and the highly sympathetic people who testify before relevant committees. By quantifying the frequency and severity of specific types of cases, you can help demonstrate the impact that Maryland's liability climate has on physician retention, access to care, and cost growth.
In other words, we want to make anecdotes actionable.
As you know, success in Annapolis is more important than ever given that the Total Cost of Care model. Far-reaching actions, such as legislation to mitigate Maryland's unfavorable medical liability climate, are key to holding costs in check at a system level.
Thank you in advance for your help with the survey and on other key issues as we prepare for the coming General Assembly session.

Nicole Stallings
Senior Vice President

MHA Submits Comments on MPA Policy
MHA this week submitted comments to the Health Services Cost Review Commission on the year two Medicare Performance Adjustment (MPA) policy. Following are the recommendations:  
  • Leverage Existing Relationships to Improve Attribution: Expand the types of physician-hospital relationships that directly link hospitals to physician practices, to take maximum advantage of existing relationships and investments.
  • Add Risk Adjustment and Attainment: Include a robust risk adjustment and recognition of attainment of a target, not just improvement from current performance.
  • Opportunity to Review and Modify: Even with improvements to the attribution logic in year two, unintended results may occur. At the start of the performance period, allow hospitals a brief period to review and revise the linkage of physicians to hospitals before finalizing the beneficiary attribution. 
An HSCRC draft recommendation is expected in October.
Nearly 600 Practices Apply for MDPCP
Physician practices applying to participate in the Maryland Primary Care Program (MDPCP) have exceeded initial projections from the Maryland Department of Health. Acceptance into the program, one of several designed to align care delivery across providers under the Total Cost of Care Model, will be determined in the coming weeks. As of the August 31 application deadline, nearly 600 had applied, exceeding the number of anticipated applicants. This means spending on the program will likely be higher than expected (a more concrete projection of those costs will be available once final participation numbers come in). As this spending increase will be counted toward the total cost of care performance beginning January 1, savings must be accelerated elsewhere to offset these costs.
Resources Available to Promote National Recovery Month
September's National Recovery Month , sponsored by the Substance Abuse and Mental Health Administration, aims to increase awareness and understanding of mental health and substance use disorders and to celebrate those in recovery. There is strong evidence that a comprehensive public health approach is effective in reducing suicide rates. Released by the U.S. Surgeon General and the National Action Alliance for Suicide Prevention, the National Strategy for Suicide Prevention is intended to guide suicide prevention actions in the United States over the next decade. September 10 is World Suicide Prevention Day. This World Suicide Prevention Day resource shows how taking a minute can change the course of another's life.
Webinars Offered on Episode Care Improvement Program
The Center for Medicare & Medicaid Innovation recently approved a voluntary Care Redesign Program track for Maryland's hospitals similar to the federal Bundled Payments for Care Improvement Advanced program. The Episode Care Improvement Program (ECIP) joins the existing care redesign programs - Hospital Care Improvement Program and Complex and Chronic Care Improvement - and will launch in January 2019.
To facilitate hospitals' participation, CRISP is making available several resources, including Excel-based tools, reference documents, and webinars. Participating hospitals' implementation protocols for the ECIP must be submitted to CRISP by October 31.
Two core webinars have already been held to train hospital staff on how to use CRISP's tools. These webinar recordings can be found on the HSCRC website .
Supplemental webinars will provide additional details and further opportunities for questions.  
  • Office Hours 1: September 20 at 9:30 a.m. Register here.
  • HCIP-ECIP Connection: September 26 at 9:30 a.m. Register here.
  • Office Hours 2: October 10 at 9:30 a.m. Register here.
  • Office Hours 3: October 29 at 9:30 a.m. Register here 
Contact: Nicole Stallings
Getting Value From Your MHEI Membership
If members of your leadership team had the opportunity to get advice from workforce consultants without having to worry about how to pay for that advice, would they take advantage of that service?

Prime Offers Solutions for Market Analyses, Intelligence and Forecasting
Prime, through its affiliation with Vizient, offers solutions through Sg2, a leading provider of health care market intelligence, strategic analytics and clinical consulting services.

Hospitals, Health Systems Launch Not-for-Profit Generic Drug Company
Several hospitals and health systems this week officially established Civica Rx - a new not-for-profit generic drug company that will help patients by addressing shortages and high prices of lifesaving medications.

Wednesday, September 12
Health Services Cost Review Commission meeting

Thursday, September 13
MHA Technical Work Group meeting
The Baltimore Sun , By Janene Holzberg, August 31
My Eastern Shore MD , By Kristian Jaime, September 5
CBS Baltimore , By Ron Matz, September 4
Baltimore Business Journal , By Barrett J. Brunsman, September 5
The Daily Record , By Staff, September 5
NBC4-Washington , By Doreen Gentzler, Sept. 6